Ryan O'Malley MD, Presenter: Nothing to Disclose

Neil Hansen MD, Abstract Co-Author: Nothing to Disclose

Zachary White Washburn MD, Abstract Co-Author: Nothing to Disclose

Mahmoud Mouhamad Al-Hawary MD, Abstract Co-Author: Nothing to Disclose

Peter Shou-Cheng Liu MD, Abstract Co-Author: Nothing to Disclose

Hero Kamal Hussain MD, Abstract Co-Author: Consultant, Bayer AG

To review causes of segmental biliary ductal dilatation, specifically emphasizing malignant obstruction. Use cases to illustrate useful findings, while noting the difficulty identifying the underlying etiology. Emphasize importance of follow-up imaging when underlying cause is not initially identified (as a significant proportion ultimately show a malignant lesion).

Review causes of segmental biliary ductal dilation: Benign - cholangitis, post-therapy Malignant - cholangiocarcinoma, hepatocellular carcinoma, metastases Present examples, particularly cases where the underlying lesion is subtle or difficult to identify. Use cases to demonstrate important findings and use of complementary sequences (e.g. DWI) to help suggest the etiology. Emphasize the importance of identifying focal biliary ductal dilation and, when present, careful scrutiny for malignant cause. Without a clear underlying etiology, close follow-up is essential to exclude developing malignancy (frequently identified on subsequent imaging). 

Segmental biliary ductal dilation is an important finding for radiologists to identify and scrutinize carefully. An underlying malignant cause is often subtle or difficult to identify at presentation, which makes close follow-up and referral to hepatobiliary subspecialists extremely important. 

O'Malley, R, Hansen, N, Washburn, Z, Al-Hawary, M, Liu, P, Hussain, H, Segmental Biliary Ductal Dilatation: Causes and Importance of Follow-up.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13028205.html